Excerpt from: Mullen & Giarusso (click for full article)
Medicaid is like the Big Dig—a big, dark hole in the ground—a federal program administered by the state. It covers care in a nursing home for those who qualify. It also provides, among other things, health insurance to the poor of all ages and people with disabilities. In the absence of any other public program covering long-term care, Medicaid is the default nursing home insurance of the middle class. As for home care, Medicaid offers very little.
While Congress and the federal government set out the rules under which Medicaid operates, each state is granted the authority to enforce the rules as it interprets them. In Massachusetts, Medicaid applications are filed in Revere, Taunton, Tewksbury and Springfield; and each processing center interprets the state regulations differently as they wish! A Medicaid application could be approved in 30 days or three years. We find however, about four months to be the norm. You can imagine the anxiety this places on the family whose loved one is in a nursing home.